. Elements of pathological anatomy. Anatomy. SECT. II.] GANGRENE : GRANULAR DISEASE. 371 am not certain that it is susceptible of this disease. At all events, very little is known respecting it. Portal asserts that it is frequently observed as a consequence of inflammation, and that it is always preceded by severe pains in the lumbar region, acute fever, vomiting, and retraction of the testicles, with scanty secretion of urine, or even entire suppression of this fluid. In persons who die of this disease, the kidney is generally tumid, softened, and pervaded by a foul, oflTensive serosity. Some
. Elements of pathological anatomy. Anatomy. SECT. II.] GANGRENE : GRANULAR DISEASE. 371 am not certain that it is susceptible of this disease. At all events, very little is known respecting it. Portal asserts that it is frequently observed as a consequence of inflammation, and that it is always preceded by severe pains in the lumbar region, acute fever, vomiting, and retraction of the testicles, with scanty secretion of urine, or even entire suppression of this fluid. In persons who die of this disease, the kidney is generally tumid, softened, and pervaded by a foul, oflTensive serosity. Some parts occasionally lose their consistence to a much greater extent than others, being of a black, livid color, and converted into a shreddy, putrilaginous substance. In chronic nephritis, the redness is of a duller hue, and the affected parts frequently exhibit a marbled aspect. The structure of the kidney becomes hard and granulated, and the patient is gradually worn out by slow, hectic fever. Diabetes is a frequent attendant on this disease. In a few cases, I have seen the kidney converted into a yellowish homogeneous mass, without being able to discern the least trace of the original textures. Its size is also sometimes very much diminished, as I have repeatedly had occasion to re- mark in my dissections. This is especially the case in the granular disease of this organ, so ably described by Dr. Bright, of London. (Fig. 75.) On tearing a kidney that is thus affected, the surface will be found studded with hard, whitish, spherical bodies, from the size of a clover-seed to that of a gooseberry: they are occasionally extremely numerous : and, in some in- stances, they project beyond the surface of the organ, so as to be discernible through its fibrous envelope. What the nature of these bodies is, is still a litigated point. The most plausible opinion, I think, is that which refers them to a hypertrophied condition of the granulations which are supposed, by Malpighi and others,
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